Objective To explore the pathogeny, pathology, ultrasonic and clinical expression of upper extremity deep venous flow obstruction and superior vena cava syndrome. Methods Retrospective analysis and summarize the disease changes of 10 cases in recent 5 years. Results 7 patients of 10 cases were superior vena cava syndrome, in which 4 cases caused by upper right lung malignant tumor, 3 cases caused by upper and media mediastinal malignant tumor. 2 patients of 10 cases were found thrombosis in right subclavian vein caused by duct of artificial pacemaker. The left 1 patient was no reason thrombosis in right axillary vein. Conclusion Ultrasonography combine with color and spectral Dopper image can evaluate the clinical development and therapeutic efficiency, which is a useful and effective non-invasive examination.

Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.

OBJECTIVETo explore the clinical efficacy and action mechanism of acupuncture for premature ovarian failure (POF).

METHODSAccording to prospective cohort study design, 30 cases were included. Based on theory of regulating Chong and Conception Vessels as well as soothing the liver and calming the nerves, acupuncture at Guanyuan (CV 4), Dahe (KI 12), Taixi (KI 3), Taichong (LR 3), Baihui (GV 20) was applied, three times per week and 3 months were considered as one session. Totally two sessions were performed. The menstruation condition, estradiol (E2), follicle-stimulating hormone (FSH) and scores of the clinical perimenopausal symptoms were taken as treatment outcomes.

RESULTSThe total effective rate was 86.7% (26/30) and the cured rate was 16.7% (5/30). The recovery rate of menstruation was 16.7% (5/30) and the regain rate of menstruation was 56.7% (17/30). After the treatment, the level of E2 was significantly increased from (45.41 +/- 18. 09) pmol/L to (59.07 +/- 24.21) pmol/L (P < 0.05), and the score of perimenopausal symptoms was obviously reduced from 14.28 +/- 8. 30 to 4.04 +/- 3.28 (P < 0.01). However, no statistical differences could be seen in FSH before and after treatment (P > 0.05).

CONCLUSIONAcupuncture has certain effect on improving menstruation and perimenopausal symptoms in POF patients, which is likely to he related with increasing the level of E2.

Acupuncture Therapy ; Adolescent ; Estradiol ; metabolism ; Female ; Humans ; Luteinizing Hormone ; metabolism ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prospective Studies ; Young Adult

The quality of guidelines of clinical practice in acupuncture and moxibustion was evaluated with AGREE II tool. After retrieval of officially-issued guidelines of clinical practice in acupuncture and moxibustion from 2004 to 2013, totally 5 types of evidence-based guidelines of clinical practice in acupuncture and moxibustion were acquired, including depression, herpes zoster, pseudobulbar palsy after stroke, migraine and Bell's palsy. With AGREE II tool, independent score in six areas, including guideline's scope and purpose, participants and personnel, preciseness, clarity and readability, applicability and editorial independence were analyzed to perform a comprehensive evaluation in the end. The assessment results indicated that the score of editorial independence in evidence-based guidelines of clinical practice in acupuncture and moxibustion was the highest, averagely 97.9%, which was followed by clarity and readability (83.3%), participants and personnel (78.1%), preciseness (75.6%), the scope and purpose (68.1%) and the applicability (62.5%). The total evaluation score was all 6 points in the five guidelines with recommended as comprehensive evaluation advice. This study results indicate that although the guideline of clinical practice in acupuncture and moxibustion is low in number, the total quality is considerable.
Acupuncture Therapy ; standards ; Evidence-Based Medicine ; Humans ; Moxibustion ; standards ; Practice Guidelines as Topic ; Quality Assurance, Health Care

Objective To investigate the expression and the possible clinical significance of serum Golgi protein(GP73)in infantile hepatitis syndrome(IHS)by different causes.Methods Totally 79 patients with IHS in Guangzhou Women and Children's Medical Center from February 2012 to December 2012 were enrolled in this study,including 15 cases with biliary atresia(BA)group,29 cases with infection(infection group),5 cases with neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD group),and 30 cases with unknown etiology(idiopathic infantile hepatitis group).At the same time,30 healthy infants were enrolled as healthy control group.The serum levels of GP73 were determined by quantitative enzyme-linked immunosorbent assay(ELISA),and the children's liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),alkaline phosphatase(ALP),γ-glutamyl trans-peptidase(γ-GT),total bile acid(TBA)and albumin(ALB)] were measured by turbidimetric inhibition immuno assay.Then,the corresponding data were statistically analyzed.Results Serum GP73 in BA group,infection group,NICCD group,idiopathic infantile hepatitis group and the healthy control group were(296.6±67.5)μg/L,(185.1±66.4)μg/L,(199.2±87.1)μg/L,(181.7±74.2)μg/L and(65.3±17.0)μg/L,respectively.Serum γ-GT levels in BA group,infection group,NICCD group,idiopathic infantile hepatitis group and healthy control group were(764.7±775.8)U/L,(448.2±352.7)U/L,(239.4±88.7)U/L,(283.3±377.2)U/L and(54.0±72.6)U/L,respectively.The levels of GP73 and γ-GT were significantly higher in infants with IHS,and the levels of GP73 and γ-GT in infants with BA were the highest(F=46.775,9.238,all P<0.05).There was a positive correlation between serum levels of GP73 and γ-GT(r=0.280,P<0.05),and there was no correlation between GP73 and ALT,AST,TBIL,DBIL,ALP,TBA,ALB(r=-0.061,-0.071,0.164,0.123,0.137,0.008,-0.047,respectively,all P>0.05).The receiver operating characteristic curve(ROC)constructed with GP73 showed a sensitivity of 80.0％and specificity of 82.8％with an area under the receiver(AUC)of 0.872 for diagnosis of BA,comparatively,a sensitivity of 66.7％and specificity of 71.9％were showed with a AUC of 0.731 when performed with γ-GT.Conclusions Serum GP73 concentration significantly increased in all liver disease groups,regardless of the etiology.Serum GP73 expression is significantly higher in infants with BA.Serum GP73 shows a superior sensitivity and specificity to γ-GT for diagnosis of BA,which might be useful for early diagnosis of BA and IHS with different causes.

OBJECTIVE To discuss the operative plan for nasal cavity abnormality and evaluate the effect of revision FESS. METHODS A retrospective study of 36 revision FESS performed during 2002.3-2005.5 (age from 17 to 55 years old) is presented. Patients were evaluated with endoscopic examination of the nasal cavities and computed tomography of the sinuses and nasal cavities. Information was also collected during the revision surgery. The plan was designed according to nasal cavity abnormality. RESULTS The reasons of revision FESS: Among 36 cases there are 24 ethmoid sinusitis, 16 cases with recurrence of polyps,13 middle meatal stenosis, 11 middle turbinate adhesion, 10 septal deviation, 5 frontal recess stenosis, 5 sphenoid sisusitis, 3 maxillary ostium obstruction,3 inferior turbinate hypertrophy. Follow up for 6 month～43 month after revision FESS, 22 cases were successful, 10 satisfied and 4 inefficacy. CONCLUSION The primary FESS failure was associated with nasal cavity structure diseases. Meticulous attention in these areas and correcting it during surgery may reduce recurrence and ensure operative effect after revision FESS.

Objective To study the clinical value and the safety of endoscopic retrograde cholangio-pancreatography(ERCP)for chronic pancreatitis in the pediatric population.Methods Clinical data,endo-scopic reports,and radiography of chronic pancreatic patients aged from 2 to 17 years old who underwent ERCP between Jan.1,2008 and Apr.30,2014 at Endoscopy Center of Ruijin Hospital were reviewed.These patients were divided into 3 groups,patients aged from 2 to 6 years old as children group(n =27),patients aged from 7 to 12 years old as juvenile group(n =35)and patients aged from 13 to 17 as adolescent group(n =25). Their clinical data and complications were analyzed by groups.Results A total of 170 ERCP procedures were performed in 87 patients,with the success rate of 99.4%(169 /170).All patients were diagnosed as having chronic pancreatitis by ERCP.Success rates of children group,juvenile group and adolescent group were 97.6%(40 /41),100.0%(72 /72)and 100.0%(57 /57)respectively.There was no statistically significance among the three groups(P =0.207).No serious complications like bleeding or perforation occurred.No proce-dure-related mortality occurred in this study either.The rate of post-ERCP adverse events in children group, juvenile group and adolescent group were 41.5%(17 /41),25.0%(18 /72)and 24.6%(14/57),respective-ly.Children group had more adverse events than the juvenile group(P =0.039)and adolescent group(P =0.045).Conclusion Pediatric ERCP is highly effective in the pediatric population with chronic pancreatitis. The incidence of post ERCP adverse events is higher among the youngest children.

This study investigated the effect of puerarin on human umbilical vein endothelial cells (HUVEC) injured with hydrogen peroxide (H₂O₂). HUVEC were divided into three groups: a control group, a model group (H₂O₂ 400 μmol·L^-1) and a puerarin-treated group (3, 10, 30 and 100 μmol·L^-1). HUVEC were cultured with varied concentration of puerarin for 2 h and treated with H₂O₂ for another 24 h. Cell proliferation was detected by a CCK-8 assay. The mitochondrial membrane potential was measured by a JC-1 fluorescent probe. A transwell chamber assay was adopted to observe cell migration ability. Mitochondrial respiratory function was measured in a two-chamber titration injection respirometer (Oxygraph-2k). The expression of interleukin-1β (IL-1β), interleukin-18 (IL-18) and tumor necrosis factor-α (TNF-α) was detected by quantitative real-time PCR. The expression of pyroptosis-mediated proteins, including cleaved-cysteinyl aspartate-specific proteinase-1 (caspase-1), N-gasdermin D (N-GSDMD), NOD-like receptor protein 3 (NLRP3) and purinergic ligand-gated ion channel 7 receptor (P2X7R) was detected by Western blot. The results show that 400 μmol·L^-1 H₂O₂ treatment for 24 h causes obvious damage to HUVEC. Compared with the model group, puerarin protected against cellular injury in a dose-dependent manner, with the greatest effect at a dose of 30 and 100 μmol·L^-1. Puerarin significantly decreased the mitochondrial membrane potential and improved mitochondrial function. Puerarin inhibited cell migration induced by H₂O₂, suppressed the expression of IL-1β, IL-18 and TNF-α, and down-regulated the pyroptosis-mediated protein. These changes are statistically significant (P < 0.05). These findings demonstrate that puerarin has a protective effect against H₂O₂-induced oxidative damage of HUVEC by inhibiting the migration of HUVEC cells. The mechanism may be related to improved mitochondrial respiratory function and inhibition of pyroptosis.

Objective: To analyze the effect of acupuncture versus hormone replacement therapy (HRT) for premature ovarian insufficiency (POI). Methods: China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), Web of Science, Cochrane Library, PubMed, and Excerpta Medica Database (EMBASE) were searched up to January 31st, 2019 to identify randomized controlled trials (RCTs) evaluating the effect of acupuncture for POI. The primary outcome was the level of basal serum follicle- stimulating hormone (FSH). Secondary outcomes included serum levels of luteinizing hormone (LH), estradiol (E2) and anti-Müllerian hormone (AMH). Two authors extracted data independently and assessed the risk of bias and the methodological quality using the Cochrane's tool. Meta-analysis was conducted by RevMan version 5.3. Results: Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level (MD=-5.82, 95％CI:-9.76 to -1.87, I2=82％, P=0.004) and a remarkable elevation in the basal E2 level (SMD=0.93, 95％CI: 0.34 to 1.52, I2=88％, P=0.002) in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone (MD=-4.53, 95％CI:-8.96 to -0.10, I2=73％, P=0.04) and acupuncture plus HRT (MD=-9.60, 95％CI:-17.60 to -1.61, I2=50％, P=0.02), while a remarkable elevation of E2 was only found in acupuncture plus HRT (SMD=1.43, 95％CI: 1.03 to 1.82, I2=0％, P<0.00001). There was no significant difference in the LH level between acupuncture and HRT (MD=-3.16, 95％CI:-9.41 to 3.10, I2=0％, P=0.32), only one trial reported AMH, and no significant difference was found between acupuncture and HRT. Conclusion: The present study indicated that acupuncture had an advantage over HRT in reducing serum FSH level and increasing serum E2 level in women with POI. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. Hence, this conclusion still needs to be verified by high-quality RCTs.

AIMTo observe the effects of ouabain on vascular smooth muscle (VSM) of the guinea pig and its interactions with Ca2+ and norepinephrine (NE).

METHODSUsing isolated thoracic aortic ring of the guinea pig, the degrees of contractile activity of drugs were recorded.

RESULTSOuabain showed a direct contractile effect in a concentration-dependent manner on thoracic aortic ring of guinea pig. Ouabain shifted the NE dose-response curve to the left without changing in the maxium response. Ouabain shifted the CaCl2 dose-response curve to the left and upward, increased the maximum response to Ca2+; In Ca(2+)-free medium, the ouabain induced contraction was abolished, an increase in extracellular Ca2+ restored the response; nifedipine and verapamil abolished the ouabain induced contraction.

CONCLUSIONThe ouabain induced contraction is mainly dependent on the extracellular Ca2+ concentration, independent on the presence of endothelia of aorta, suggesting that Ca2+ antagonist may treat the hypertension induced by ouabain. Ouabain, NE and CaCl2 have synergetic contractile effects, suggesting that the synergetic contractile effects of ouabain and NE may contribute to the generation and development of hypertension.

Animals ; Aorta, Thoracic ; drug effects ; Calcium ; metabolism ; Calcium Channel Blockers ; pharmacology ; Calcium Chloride ; pharmacology ; Drug Synergism ; Female ; Guinea Pigs ; Male ; Muscle Contraction ; drug effects ; Muscle, Smooth, Vascular ; drug effects ; Nifedipine ; pharmacology ; Norepinephrine ; pharmacology ; Ouabain ; pharmacology ; Verapamil ; pharmacology